Brothers to Brothers/Sisters to Sisters

The recent public health statistics show that some minority groups in the US are at especially high risk for contracting HIV/AIDS. Through funding from the Center for Substance Abuse Treatment (CSAT/SAMHSA), SARDI has established the Brothers to Brothers/Sisters to Sisters Program to lead a coalition which consists of substance abuse treatment providers, the county health department, an AIDS Service Organization, faith-based providers, homeless shelters, and other providers in order to increase access to substance abuse treatment, as well as increase access to HIV testing and education. Since its inception, the Coalition has also seen the addition of an active citizen advisory board that identifies itself as "Citizens Against Death." Functioning as a community-wide effort, Brothers to Brothers/Sisters to Sisters offers expanded and enhanced services to persons at high risk for, or living with, HIV/AIDS.

The Coalition addresses the addiction treatment needs of primarily African American adult men and women with, or at high risk for, HIV/AIDS, and members from Dayton's other communities of color. The SARDI Program began this initiative in part because of its history of involvement in issues related to minority health, HIV, and substance abuse, as well as its expertise in evaluation and program development.

BB/SS Background

At the current time approximately 45% of HIV/AIDS cases in Montgomery County Ohio, involve African Americans, an increase from previous years. Twenty-five percent of all cases involve women. Although these statistics illustrate the heightened risks of the minority population, they do so inadequately. Only one-half or less of individuals with HIV/AIDS are reported in local systems, due to people hiding their condition or not wanting to know their test outcomes. According to health officials, additional barriers exist in Montgomery County regarding HIV blood testing, which is frequently avoided by individuals of the at-risk population. Testing protocols and notification spans not only a decreased number of persons being tested, but also a decreased test site capacity to notify individuals. Furthermore, not all testing sites contribute information to the CDC-maintained database.

From July 1999 to June 2001, there were 1,136 new individuals diagnosed with HIV and 916 diagnosed with AIDS. The CDC estimates that in Dayton, and other cities across the nation, 1 in 50 African American men are believed to be infected with HIV and 1 in 160 African American women are believed to be infected. In comparison, 1 in 250 Caucasian men and 1 in 3000 Caucasian women are believed to be infected. Although African-Americans make up 13% of the U.S. population, they represent 48% of all reported AIDS cases. It is the leading cause of death for African Americans, ages 25-44. AIDS mortality rates remain nearly 10 times higher among African Americans than among Caucasians.

Recent estimates suggest that the HIV/AIDS epidemic in the Dayton area is being driven by sub-epidemics in three groups:

Injection drug users and their sexual partners;

Heterosexual women who use crack; and

Men of color who have sex with men (Holmberg, 1996)

Of these three sub-groups, two are directly associated with drug use and underscore the importance of drug use and sexual behaviors to the spread of HIV. In addition, there is evidence that the third sub-epidemic also is associated with drug use. Among MSMS, non-injection drug use (e.g., current or past heavy alcohol use; current use of stimulants, hallucinogens, and inhalants [Woody et al., 1996]), has been shown to be associated with higher-risk sexual behavior.

Public Health — Dayton and Montgomery County: Operates two community clinics providing general health care, including free clinics for persons with HIV and also STDs. Conducts multiple Health Fairs during year to promote health awareness in schools, churches, public and special events. The district also sponsors outreach activities within communities for related topics/issues.

Project C.U.R.E.: Project C.U.R.E provides opioid treatment with modalities that range from methadone maintenance to residential care. The project is capable of intake of up to 300 new persons annually, with an active caseload over 450. Approximately 45% of its clientele are African American.